High blood pressure (hypertension)

What the numbers mean

A reading has two numbers. The first (systolic) is the pressure in your blood vessels when your heart beats. The second (diastolic) is the pressure when your heart rests between beats. The NHS usually considers your blood pressure high if it is:

WHO describes hypertension as diagnosed when readings on two different days are 140 or more for the first number, 90 or more for the second, or both. One high reading on its own is not a diagnosis.

Symptoms: usually none

High blood pressure does not usually cause any symptoms, and many people have it without realising. Rarely it causes headaches, blurred vision or chest pain. WHO estimates that around 600 million adults with hypertension worldwide do not know they have it.

Causes and who is more likely to get it

• Your age: it becomes more likely as you get older.
• Close relatives with high blood pressure.
• A Black African, Black Caribbean or South Asian background.
• A diet high in salt, or high in saturated and trans fats and low in fruit and vegetables.
• Being overweight, smoking, drinking too much alcohol and not being active.
• Feeling stressed over a long period.
• Other conditions such as diabetes or kidney disease.

How it is checked

A cuff is inflated around your upper arm and the pressure is measured. If the reading is high, you may be asked to check it at home over several days, come back for another reading, or wear a portable monitor that takes readings over 24 hours. You can use a home monitor, but WHO says an assessment by a health professional is still important to look at your overall risk and related conditions.

The blood tests listed on this page do not measure blood pressure. WHO notes that raised blood pressure, raised blood glucose and raised blood lipids together point to a higher risk of heart attack and stroke, and that hypertension can damage the kidneys, so a doctor may suggest tests of your cholesterol and kidney function as well.

How it is usually managed

• Eat a healthy, balanced diet and cut down on salt, including salt added at the table.
• Aim for at least 150 minutes of exercise a week.
• Lose weight if you are overweight.
• Cut down on alcohol and on drinks high in caffeine, such as coffee, tea and cola.
• Do not smoke.

A doctor will usually suggest medicine if your blood pressure is very high, if you are at higher risk of a heart attack or stroke, or if it stays high after lifestyle changes. The choice depends on how high it is, your age and your ethnicity. Most are tablets taken once a day, and some people need more than one. Your target depends on your other conditions: WHO gives below 140/90 for most people and below 130/80 for people with, or at high risk of, heart disease or stroke.

Complications to know about

High blood pressure puts extra strain on your blood vessels, heart, brain, kidneys and eyes. Left untreated, it raises the risk of heart disease, heart attack, stroke, heart failure, kidney disease and vascular dementia. The NHS points out that lowering your blood pressure even a small amount helps reduce these risks.

High blood pressure in the UAE

The UAE is part of the WHO Eastern Mediterranean Region, which WHO reports has the highest share of adults with hypertension of any of its regions, at 38%. Because it is common and often silent, a regular check is worth planning.

If you have a heart condition as well, the NHS lists people with heart problems among those more at risk of heat exhaustion and heatstroke, so take extra care in the summer. Keep a home log of the date, time and reading to share with your doctor, as the cardiology guide explains.

When to see a doctor, and when to call 998

Call 998 straight away for sudden chest pain or discomfort that does not go away, which can feel like squeezing, pressure, burning or indigestion; pain that spreads to your arm, neck, jaw, stomach or back; or chest pain with sweating, feeling sick, light-headed or short of breath. Also call 998 for sudden weakness or numbness of the face, arm or leg, sudden confusion or trouble speaking, or sudden difficulty seeing. Do not drive yourself to hospital.

WHO says that very high blood pressure, usually 180/120 or more, can cause a severe headache, chest pain, dizziness, difficulty breathing, blurred vision or confusion, and that anyone with these symptoms and a high reading should seek care immediately. Get advice the same day if you often have headaches or blurred vision, or chest pain that comes and goes.

For a routine check, the NHS suggests getting your blood pressure measured if you are 40 or over and it has not been checked for more than 5 years, or sooner if you think you are at risk. Doctors on medicAI work for independent facilities licensed by DHA or DoH, and a video call can cover a review of your home readings and medicines.